Provision of services

Theme 1: The right provision of voluntary, community, and formal services promotes independence by building stronger and more resilient communities; helping an individual with some form of recovery, rehabilitation or reablement; or by effectively supporting those individuals who have longer-term care needs.

Adult social care needs to offer a provision of local services that empowers individuals to live their best life. Individuals need to have a say in what they receive, how they receive it, when they receive it, when service levels will be reviewed, and why they receive what they get – whilst practitioners should appropriately challenge and support the individual to be ambitious about how independently they can live their life. 

There needs to be clarity on how to access informal and formal services, whether the individual is being referred by someone else, or seeking to refer themselves. 

There also needs to be a wide range of services available that meet individuals’ needs in the following ways:

  1. Voluntary and community sector services that help people to be involved in society and lead more fulfilling lives. These services both prevent individuals going into crisis and reduce their need for formal support.

    Effective and accessible voluntary and community sector services (including those not directly commissioned by the council) help individuals to be involved in society and lead more fulfilling lives. They play a crucial role in both preventing individuals going into crisis and reducing their need for formal support.

Key findings: 

  • VCS services help promote the well-being and social inclusion of the person, often through fostering independence.
  • These services can be crucial in reducing the risk of some individuals needing social care, providing an important preventative role in the adult social care offer.
  • VCS services also play a vital role in supporting those providing informal care through assistance and respite services. 
  • Although there is little data available on effectiveness, what data this project uncovered appears to demonstrate value.  For example, in one council, it was found that increasing the use of voluntary and community sector services for individuals receiving small packages of care would result in a cost saving of £1,082 per individual.

  1. Short-term services that help an individual with some form of recovery, rehabilitation or reablement and are effective at reducing or eliminating their need for long-term care

    Short-term services are highly effective at reducing or eliminating an individual’s need for long-term care. They can help a person achieve their goals and to develop approaches that may reduce or eliminate their need for long-term care. This may involve regaining or improving aspects of their personal confidence or independence, their strength or their health.

Key findings:

  • Short-term services are extremely effective at promoting and supporting an individual’s independence.
  • They also offer a high return on investment. For example, analysis of 11 different services shows the average amount of long-term care and support required after one such short term service, ‘reablement’, is £8700 cheaper than if they had not received reablement. This is a return on investment of seven times the cost of the short-term intervention.
  • Excellent authorities place short-term services at the heart of achieving independent outcomes and managing demand, prior to delivering long-term services.

  1. Long-term services, including domiciliary and forms of bedded care, continue to maximise the independence and prevent the escalation of needs of individuals

    Once individuals have been through a short-term intervention, and made the most of community support, there needs be a wide range of services for those people who have longer-term care needs. These services should continue to promote and support them to achieve the best quality of life and level of independence.

Key findings:

  • Spend on long-term services accounts for £14.6bn (78%) of the £18.7bn total Adult Social Care gross current expenditure. Although there are far more older adults in receipt of long-term care than adults of working age, there is an even split between spend on those cohorts, due to the higher unit costs of supporting adults of working age.
  • Authorities shape their long-term service provision ahead of evolving trends in specialist population need, such as mental health conditions.
  • Care providers have a unique relationship with the individuals they support and understand their aspirations and needs. Excellent providers are motivated by a set of beliefs to improve the quality of life of their clients.
  • For people in receipt of long-term packages of care (residential or domiciliary), the extent to which they will have their independence sustained is influenced by the supplier of that care.
  • Digital technology is woven into the fabric of service provision. However, decisions made on any new technology are based on the evidence that it will demonstrably improve outcomes which match the individual’s aspirations.